Healthcare Provider Details

I. General information

NPI: 1407514672
Provider Name (Legal Business Name): YAMILEE C CABROL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2021
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2675 WINKLER AVE FL 2
FORT MYERS FL
33901-9342
US

IV. Provider business mailing address

2675 WINKLER AVE FL 2
FORT MYERS FL
33901-9342
US

V. Phone/Fax

Practice location:
  • Phone: 239-226-2727
  • Fax: 239-939-9876
Mailing address:
  • Phone: 239-226-2727
  • Fax: 239-939-9876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11015919
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number11015919
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: